NHS Schools Funding- 2017

1. NHS Schools Funding- 2017 Mark Whiting, Consultant Nurse, Children with Complex Health Needs, Hertfordshire Community NHS Trust.

2. Supporting Pupils at School with Medical Conditions • Originally published in September 2014, and re-issued in December 2015 with some minor revisions. • Places a whole new raft of statutory responsibilities upon school governors. • Web page also includes a set of templates for: • health care plans, • medicines administration record, • parental agreement, • staff training records etc. • And… an extensive list of web-linked resource materials.

3. Supporting Pupils at School with Medical Conditions – some key paragraphs • 5. The governing body must ensure that arrangements are in place to support pupils with medical conditions. In doing so it should ensure that such children can access and enjoy the same opportunities at school as any other child. • 15. The governing body should ensure that the school’s policy clearly identifies the roles and responsibilities of all those involved in the arrangements they make to support pupils at school with medical conditions. • 18. The school’s policy should be clear that any member of school staff providing support to a pupil with medical needs should have received suitable training. • 19. Staff must not give prescription medicines or undertake healthcare procedures without appropriate training (updated to reflect requirements within individual healthcare plans).

4. Supporting Pupils at School with Medical Conditions – some key paragraphs • Training should be sufficient to ensure that staff are competent and have confidence in their ability to support pupils with medical conditions, and to fulfil the requirements as set out in individual healthcare plans. They will need an understanding of the specific medical conditions they are being asked to deal with, their implications and preventative measures. • A first-aid certificate does not constitute appropriate training in supporting children with medical conditions. • Healthcare professionals, including the school nurse, can provide confirmation of the proficiency of staff in a medical procedure, or in providing medication. • The school’s policy should additionally set out arrangements for whole-school awareness training so that all staff are aware of the school’s policy for supporting pupils with medical conditions and their role in implementing that policy.

5. Hertfordshire NHS Schools Funding • Established 2010 in order to provide a consistent process for provision of NHS funding for children requiring specific ‘clinical care in school/early years settings. • Up to this point, funding was very inconsistent. • Process requires schools/early years settings to apply for funds. • Available to mainstream settings and, in exceptional circumstances, special schools. • Application must be supported by an appropriate health professional – most are supported by CCNs, Continuing Care Teams, Children’s Diabetes Nursing Teams, Special School Nurses and School Nurses.

6. Hertfordshire NHS Schools Funding • School may make applications throughout the year and decisions made within 2 months. • If approved funding is reviewed annually (Summer term) • Health Professionals are encouraged to attend funding Panel • Funding decisions based upon determination that child has a demonstrable ‘clinical need’ • Panel considers nature, frequency and predictability of clinical interventions.

7. Hertfordshire NHS Schools Funding • Funding 2014 = £246,000 for 62 pupils • Funding 2016 = £338,000 for 88 pupils • Clinical Care Need/Diagnosis • Diabetes: 51 children (25 in 2014) • Gastrostomy feeding: 16 children • Tracheostomy care/Suction 8 children • Complex needs in Special School: 7 children • Catheterisation • Stoma care • Respiratory care/support/physiotherapy • Skin care – not particularly complex, but regular and as treatment for a complex medical condition. • Physiotherapy directed daily stretching/exercise programme

8. Hertfordshire NHS Schools Funding Who is responsible for providing the necessary resources to ensure that care needs are met? Which children need an EHCP? If a child needs a health care plan do they also need an EHCP? What is the legal status of ‘health care’ provision that is set out within an EHCP? – During the school day? At times when the child is not at school? Is it health care or education ‘duty of care’ or ‘social’ care? • Toileting – particularly where there is an underlying medical/organic cause. • Danger of injury due to seizure/unsteadiness • Intimate/personal care